In Michigan, insurance companies mandate an official autism assessment from an Autism Assessment Evaluation Center (AAEC) before approving ABA (Applied Behavior Analysis) therapy services. However, long wait times at AAECs (1-2 years or longer) prompt most parents to seek an earlier autism assessment from a qualified health professional trained in the ADOS or ADOS-2 protocol. This allows parents to initiate ABA therapy sooner by obtaining a bridge authorization through their insurance carrier.

A “qualified health care professional” is someone trained to conduct diagnostic evaluations using approved methods and protocols. Such professionals may include pediatric neurologists, developmental pediatricians, board-certified pediatricians, board-certified child psychiatrists, fully licensed child psychologists, or medical doctors experienced in diagnosing ASD.  

Dr. Norma Love Schropshire is a licensed clinical social worker trained to administer the ADOS/ADOS 2 protocols.

Official Blue Cross Blue Shield Rules for 2021 BCBSM/New Directions Applied Behavior Analysis Medical Necessity Criteria (PDF) The criteria in this document are used by BCBSM and providers to make benefit determinations for applied behavior analysis services for autism. Source: https://www.bcbsm.com/important-information/policies-practices/behavioral-health/

How To Get A Bridge Authorization For Autism ABA Services In Michigan

To obtain a bridge authorization for ABA services in Michigan, follow these steps:

1. Receive an official diagnosis and report from a qualified health care professional. Dr. Norma Love Schropshire is a licensed clinical social worker trained to administer the ADOS/ADOS 2 protocols.

2. Have your Board Certified Behavior Analyst (BCBA) submit a plan of action for ABA therapy to your insurance carrier to request an “ABA bridge authorization” for services. This allows your child to start receiving ABA therapy while waiting for an assessment at an AAEC site.

BCBAs are professionals certified by the Behavior Analyst Certification Board (BACB) and qualified to design, implement, and evaluate behavior-analytic interventions for individuals with autism and other developmental disabilities. They also ensure that ABA therapy is based on the latest research and best practices in the field of Applied Behavior Analysis.

We recommend contacting an AAEC center to join their waitlist while simultaneously scheduling an autism testing appointment with Dr. Norma Love-Schropshire or another qualified health professional of your choice. This approach ensures your child receives necessary ABA services without wasting any more valuable time.

You can find a complete list of Approved Autism Evaluation Centers below and click here.

Blue Cross Blue Shield Approved Autism Evaluation Centers and 

Licensed Behavior Analysts

Steps To Take If Your Insurance Covers ABA Services in MI

This guide shown below is intended to assist you in understanding the process to have your child assessed for Autism Spectrum Disorder (ASD), establish their eligibility for Applied Behavior Analysis (ABA) services, secure insurance coverage for these services, and eventually access ABA services.

The diagram below illustrates a potential scenario: if your insurance policy mandates an AAEC evaluation but has a waitlist exceeding two months, you’re permitted to pursue a temporary ‘bridge’ evaluation. This evaluation can be conducted by Dr. Norma Love-Schropshire, a qualified healthcare professional, and it allows you to initiate ABA services while you wait for the official AAEC assessment.

Steps To Take If Your Insurance Does Not Cover ABA Services In MI

First, you should reach out to your employer’s Human Resources department and inquire whether they can opt to include ABA services in their healthcare contract. If your employer declines to include this coverage, you may explore the following alternatives:

1. Check if your child qualifies for coverage through Medicaid.

2. Consider purchasing an additional insurance plan that includes ABA services.

3. Consult with an advocacy organization for further advice and assistance.

Approved Autism Evaluation Center Frequently Asked Questions

How Many Approved Autism Evaluation Centers Are Available in Michigan?

There are roughly 18 Approved Autism Evaluation Centers (AAEC) located throughout Michigan. You can find a complete list at this link: Approved Autism Evaluation Centers in Michigan.

What Is the Typical Wait Time for an Autism Evaluation at an AAEC Site?

While it’s hard to give an exact timeframe, our clients often report waiting between 1 to 2 years for an evaluation at an AAEC site.

What Steps Can I Take If I Don’t Want to Wait That Long for an Evaluation?

If you’re looking to expedite the process, we recommend scheduling an autism assessment with Dr. Norma Love-Schropshire, a qualified, licensed provider. Such a provider can issue a “bridge authorization,” allowing you to access Applied Behavior Analysis (ABA) services while you wait for your AAEC evaluation. This ensures you don’t miss out on valuable treatment time. 

This Process Seems Complicated. Could You Outline the Steps to Receive ABA Services While Waiting for My AAEC Appointment?

Absolutely, waiting for 1-2 years for services is far from ideal, especially given the condition at hand. We always emphasize to families that early intervention is crucial; the younger the child receives treatment, the better the outcomes are likely to be.

Step 1: Schedule an Autism Testing Appointment with a qualified provider, Dr. Norma Love-Schropshire. This initial assessment is known as a “Bridge Evaluation.”

Step 2: If the diagnosis confirms autism, provide the diagnostic report to your Board Certified Behavior Analyst (BCBA). They will then submit this report to your insurance company to initiate a bridge evaluation, allowing you to start receiving ABA services.

Listen to How To Get An Autism Diagnosis and Services…by Dr. Kat Lewitzke

How To Get An Autism Diagnosis and Services. Actionable Advice For Parents Through Personal Experience

Sharon Tonnies is a twin mom and an autism advocate. She and her husband, have 16-year-old twin boys, and have been married for 19 years. Sharon supports the Autism Alliance of Michigan and is currently on the Board of Directors for the Michigan Council of Exceptional Children as well as the Consumer Advisory Board for the Judson Center.

In this episode of Psych Confidential, Dr. Kat Lewitzke and Sharon discuss Sharon’s story and offer invaluable advice to families who are facing difficult decisions and questions surrounding the diagnosis, treatment options, and how to navigate through in a healthy and proactive manner. They offer words of encouragement and a comprehensive plan to get the services your child deserves.